Long-term effect of motivational interviewing on clinical and psychological outcomes and health-related quality of life in cardiac rehabilitation patients with poor motivation in Hong Kong: a randomized controlled trial

Abstract

Objective: To investigate the long-term effects of motivational interviewing on clinical outcomes, psychological outcomes, health-related quality of life among cardiac rehabilitation patients with poor motivation.

Design: A randomized controlled trial with blind data collectors.

Setting: Cardiac rehabilitation centre.

Subjects: A total of 146 cardiac rehabilitation patients with poor motivation.

Intervention: All participants received usual care, including exercise and education, while those in the experimental group also received 10 sessions of motivational interviewing, each lasting 30-45 minutes.

Main measures: Clinical and psychological outcomes and health-related quality of life were assessed at baseline and at six, nine and 12 months for both groups.

Result: There was no significant difference between the two groups at baseline on demographic and clinical outcomes except for monthly family income (p = 0.034). Patients in the experimental group had higher increases in health-related quality of life (SF-36) scores in bodily pain (88.7 SD 16.7 vs. 87.6 SD 18.7 at month 12, p = 0.044) and role limitation owing to emotional problems (86.9 SD 19.2 vs. 78.6 SD 21.8 at month 9, p = 0.019; 85.8 SD 18.9 vs. 76.9 SD 23.9 at month 12, p = 0.022). No statistically significant group difference was found among other outcomes.

Conclusion: The long-term effect of motivational interviewing on clinical and psychological outcomes and health-related quality of life in studied patients is limited.

Keywords: Cardiac rehabilitation; coronary heart disease; motivational interviewing; randomized controlled trial.